Healthcare Provider Details
I. General information
NPI: 1316839822
Provider Name (Legal Business Name): TRANQUILITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 FAIRFAX CT
VALLEJO CA
94591-4737
US
IV. Provider business mailing address
2041 EAST ST STE 701
CONCORD CA
94520-2126
US
V. Phone/Fax
- Phone: 707-731-1132
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANA
TANNER
Title or Position: ADMIN ASSISTANT
Credential:
Phone: 801-819-6675